Active NPI
Kelly Kriklava, P.A.
- Physician Assistant
- Cincinnati, OH
National Provider Identifier
1487193132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.007959RX
- Practice address
- 3333 Burnet Ave, ML 1013
Cincinnati, OH 45229 - Phone
- (513) 636-4466
- Fax
- (513) 636-5846
- NPI assigned
- Feb 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0006386 | MD | |
| Physician Assistant | 363A00000X | PA9111155 | FL | |
| Surgical Physician Assistant | 363AS0400X | 4542 | TN | |
| Physician Assistant | 363A00000X | 50.007959RX | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave, ML 1013
Cincinnati, OH 45229
Mailing address
PO Box 417
Stuart, FL 34995-0417
Phone (772) 781-2799
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kkriklava55871@direct.martinhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4542 | TN | MD | Physical Therapy Assistant |
| C0006386 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Memorial Physician Corporation Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Multi-Specialty Clinic/Center
- Stuart, FL
- NPI 1578505228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1487193132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417",
"city": "STUART",
"state": "FL",
"postal_code": "349950417",
"telephone_number": "772-781-2799",
"fax_number": "772-781-2716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE, ML 1013",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-636-4466",
"fax_number": "513-636-5846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIKLAVA",
"first_name": "KELLY",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-14",
"last_updated": "2023-03-20",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0006386",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9111155",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TN",
"license": "4542",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.007959RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kkriklava55871@direct.martinhealth.org",
"affiliation": "N",
"address_1": "3801 S Kanner Hwy Ste 200",
"city": "Stuart",
"state": "FL",
"country_code": "US",
"postal_code": "349944801",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.